Headaches have been a common malady in humans throughout history, and today still remain a major problem and source of suffering and economic loss. Many hundreds of millions of dollars are spent each year on the treatment of headaches, and yet many people are often prevented from normal daily activities due to this malady.
The malady known as headache is an amorphous disease. Its symptoms are often described by the patient in very idiosyncratic terms. Descriptions of headaches by patients include terms such as "stabbing", "burning", "throbbing", etc.; and yet, what a headache is is generally understood by everyone. Its occurrence is also heavily dependent on the particular circumstances of the patient, in some cases headaches occur in relation to stress (either physical or psychological), while in other cases they are related to environmental factors or physical activities. Headaches may occur randomly or in repetitive patterns, such as the case with migraine headaches.
The epidemiological causes of headache are highly varied, ranging from relatively minor factors, such as eye strain or neck muscle strain, to very serious pathologies, such as stroke, tumor growth, and the like. However, regardless of causative mechanism, the presenting symptom to the attending physician is often simply the complaint of headache.
Treatment of headache symptoms are as varied as the causative events. Amelioration of headache symptoms may involve the treatment initiating conditions which may seem apparently distant to the presenting complaint, (treatment of hypertension or various cancerous tumors, change of eye glasses, performing special exercises, and the like). However, the most common treatment is the palliative use of analgesics, which include aspirin, non-steroidal anti-inflammatory agents (ibuprofen, acetaminophen, etc.), opiates, ergot derivatives, and corticosteroids.
Prevention of headache is likewise an area of varied regimens, including the treatment of underlying pathologies as mentioned, supra, and changes in life-styles or stress levels. However, in cases where there are no specific initiating events, prevention of headaches with pharmacologic agents is not a common medical practice. The primary reason is that agents used to treat headaches are not usually used to prevent them, and this is due to the detrimental side-effects of those agents, e.g., the gastro-intestinal toxicity of aspirin or ibuprofen, the addictive potential of the opiates, etc. For further information, see: "Harrison's Principles of Internal Medicine", Ed. Isselbacher, K. J., et al., 9th Ed., McGraw-Hill Book Co., NYC, Chp.4, pp.18-28 (1980) and references therein.
It would be of great value to medical practice, if a pharmacologic agent were available which would prevent headache without the detrimental side-effects seen with the current headache treatment drugs.